Healthcare Provider Details

I. General information

NPI: 1972434546
Provider Name (Legal Business Name): MS. LISA BURNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA BROWN

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 HURON AVE
DAYTON OH
45417-1621
US

IV. Provider business mailing address

4079 COLONIAL PL
GROVE CITY OH
43123-3349
US

V. Phone/Fax

Practice location:
  • Phone: 513-341-5302
  • Fax:
Mailing address:
  • Phone: 937-554-8867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: